Abstract:
BACKGROUND: Shared decision-making is the process where patients and clinicians work
together to make healthcare choices. When given a choice, most patients want to participate in
decision-making about their treatment. There is a perception amongst clinicians that socioeconomically disadvantaged patients do not want to participate in shared decision-making.
This study investigated if patients visiting the Family Medicine Outpatient Clinic at Kalafong
Hospital in Gauteng, South Africa, would prefer shared decision-making.
METHODS: Cross-sectional survey was performed using the Control Preference Scale. Patients
visiting the Family Medicine Outpatient Clinic at Kalafong Hospital were purposively selected
(n = 150) between February 2016 and May 2016.
RESULTS: The patients had a median age of 52 years and 53% did not finish grade 12 at school.
Their median income was R3200.00 (South African Rand [ZAR]; less than $200.00) per month.
Nearly half (46%) of the patients surveyed had an active preference for shared decision-making
during a consultation. No demographic or disease factors had a statistically significant
association with this preference.
CONCLUSION: The perception that socio-economically disadvantaged patients do not want to
actively participate in shared decision-making is incorrect according to this study. As it is not
possible to predict which patients prefer an active approach to shared decision-making, it is
recommended that clinicians should enquire whether they would prefer shared decision
during consultations. Clinicians should also be equipped to practice this technique and an
environment needs to be created that facilitates the process.
